Source: NEJM Journal Watch
The increasing use of HIV integrase inhibitors in antiretroviral therapy has decreased the incidence of new antiretroviral drug resistance in real-world clinic situations. When resistance did emerge, classic risk factors like poor adherence and advanced immunosuppression were often present.
The British Columbia Centre for Excellence in HIV/AIDS routinely collects data on HIV-1-infected patients in their care, including antiretroviral treatment history, HIV RNA measurements, and the results of HIV resistance testing. Using these data, investigators assessed emergence of new resistance mutations in a retrospective cohort study of 928 adult HIV-infected patients initiating 985 distinct treatment regimens, each consisting of 2 nucleoside reverse transcriptase inhibitors (NRTIs) and an integrase inhibitor (INSTI) — raltegravir (270), elvitegravir (323), or dolutegravir (392).